After obtaining my IRB approval from Regis University, I was asked by the health center's medical director to present the project to the health center's Peer Review Committee (PRC), who unanimously approved the project. After the presentation, I met with the dietician who will be leading the program and discussed in detail the promotional plan and the logistics of the project. We planned to have posters posted at the waiting areas of each health center where the program will be piloted and to have educational brochures printed in English and Spanish. The posters and brochures are all downloaded for free from the Let's Go! Website, but printing is not for states outside of Maine.
We plan to have the posters posted in the three sites before the end of the year in preparation for a January 2012 start date, which will end on March of 2012. Certificates and ribbons will be given to every child/adolescent who completes the three-month program with a parent or caretaker as full participant of the program. A policy will then be created to have the program be the standard of care for child and obesity prevention/treatment at the health center. After the project, we would be able to describe the sample population, their baseline and post-intervention eating habits, physical activity levels, sedentary behaviors (screen time in particular), perceived readiness to change, and perceived barriers, benefits, and solutions. Any issues encountered during the pilot phase will be addressed before the full adaptation of the Stage 1 Prevention Plus approach recommended by the Expert Committee.
Healthcare disparity exists when inequalities occur between and among different groups when compared to each other (Shi & Singh, 2011, The Nation's Health). It is a result of a complex interplay of genetics/hereditary, environmental, and behavioral factors, and is most commonly associated with poverty and lack of education (US DHHS). Health disparity is also most often associated with race/ethnicity and socio-economic status. Children from low-income families, Mexican teenage boys, and African-American girls are disproportionately affected by obesity. Disparities in health care among Medicaid children exist when compared with privately insured children (Medstat, 2005).
Federally qualified health centers provide primary health care to medically underserved populations. Instituting a prevention/treatment program for children and adolescents at the health center will provide much needed access to evidence-based prevention/treatment programs that are patient/family-centered, timely, efficient, effective, safe, and ethical.
The longitudinal Service Learning Experience reinforced the need of working in interdisciplinary teams as recommended by the Institute of Medicine (2003). Communicating effectively, coordinating, and collaborating with partners from the health center are essential components for the success of the program. The experience helped me develop my confidence in myself and helped me to go beyond my comfort zone to ensure that quality preventive care is available to children and adolescents affected mostly by overweight and obesity. I plan to continue doing so until the program is finally the standard of care for the health center. I also plan to keep myself updated about the issue and developments in the practice and care for overweight and obese children and adolescents.
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